Radiation-induced circulating microRNAs linked to echocardiography parameters after radiotherapy.

Introduction: Patients treated with radiotherapy to the chest region are at risk of cardiac sequelae, however, identification of those with greatest risk of complications remains difficult. Here, we sought to determine whether short-term changes in circulating miRNA expression are related to measures of cardiac dysfunction in follow-up. Materials and methods: Two parallel patient cohorts were enrolled and followed up for 3 years after completion of RT to treat left-sided breast cancer. In the primary group (N=28) we used a a panel of 752 miRNAs to identify miRNAs associated with radiation and cardiac indices at follow up. In the second, independent cohort (N=56) we validated those candidate miRNAs with a targeted qPCR panel. In both cohorts. serum samples were collected before RT, 24h after the last dose and 1 month after RT; cardiac echocardiography was performed 2.5-3 year after RT. Results: Seven miRNAs in the primary group showed marked changes in serum miRNAs immediately after RT compared to baseline and associations with cardiopulmonary dose-volume histogram metrics. Among those miRNAs: miR-15b-5p, miR-22-3p, miR-424-5p and miR-451a were confirmed to show significant decrease of expression 24 hours post-RT in the validation cohort. Moreover, miR-29c, miR-451 and miR-424 were correlated with the end-diastolic diameter of the left ventricle, which was also confirmed in multivariable analysis adjusting for RT-associated factors. Conclusion: We identified a subset of circulating miRNAs predictive for cardiac function impairment in patients treated for left-sided breast cancer, although longer clinical observation could determine if these can be used to predict major clinical endpoints.

Management of valvular heart disease in patients with cancer: Multidisciplinary team, cancer-therapy related cardiotoxicity, diagnosis, transcatheter intervention, and cardiac surgery. Expert opinion of the Association on Valvular Heart Disease, Association of Cardiovascular Interventions, and Working Group on Cardiac Surgery of the Polish Cardiac Society.

The Association on Valvular Heart Disease, Association of Cardiovascular Interventions, and the Working Group on CardiacSurgery of the Polish Cardiac Society have released a position statement on risk factors, diagnosis, and management of patients with cancer and valvular heart disease (VHD). VHD can occur in patients with cancer in several ways, for example, it can exist or be diagnosed before cancer treatment, after cancer treatment, be an incidental finding during imaging tests, endocarditis related to immunosuppression, prolonged intravenous catheter use, or combination treatment, and nonbacterial thrombotic endocarditis. It is recommended to employ close cardiac surveillance for patients at high risk of complications during and after cancer treatment and for cancer treatments that may be cardiotoxic to be discussed by a multidisciplinary team. Patients with cancer and pre-existing severe VHD should be managed according to the 2021 European Society of Cardiology (ESC) and European Association for Cardio-Thoracic Surgery (EACTS) guidelines for VHD management, taking into consideration cancer prognosis and patient preferences.

Interplay between acute coronary syndromes and cancer: insights into pathophysiology, diagnostic challenges, and treatment options.

Acute coronary syndromes (ACS) and cancer are among the leading causes of death worldwide. In recent years, increasing evidence has suggested an interplay between these 2 conditions. This article reviews the pathophysiology, diagnostic challenges, and treatment options for ACS and cancer. The interplay between these conditions may be due to environmental, genetic, and metabolic factors. For example, smoking, hypertension, and obesity are risk factors for both ACS and cancer. Diagnosis of ACS and cancer can be challenging because the symptoms of these conditions often overlap. For example, chest pain can be a symptom of both ACS and a neoplasms. Treatment options for ACS and cancer are varied and depend on the type of disease, stage of disease, and individual patient factors. Treatment for ACS may include angioplasty, stenting, or medication therapy. Treatment for cancer may include surgical removal of the tumour, radiation therapy, or chemotherapy.

Clinical Characteristics, Treatment, and Short-Term Outcome in Patients with Heart Failure and Cancer.

(1) Our study aimed to look at the clinical characteristics, treatment and short-term outcomes of patients hospitalized due to heart failure with coexisting cancer. (2) Methods: Seventy one cancer (Ca) patients and a randomly selected 70 patients without Ca, hospitalized due to heart failure exacerbation in the same time period constituted the study group (Ca patient group) and controls (non-Ca group), respectively. Data on clinical characteristics were collected retrospectively for both groups. (3) Results: Cancer patients presented with a less advanced NYHA class, had more frequent HFpEF, a higher peak troponin T level, and smaller left atrium size, as compared with controls. The in-hospital deaths of Ca patients were associated with: a higher New York Heart Association (NYHA) class, lower HgB level, worse renal function, higher K and AST levels, presence of diabetes mellitus, and HFpEF. By multivariate logistic regression analysis, impaired renal function was the only independent predictor of in-hospital death in Ca patients (OR-1.15; CI 1.05; 1.27); p = 0.017). The following covariates entered the regression: NYHA class, HgB, GFR, K+, AST, diabetes mellitus t.2, and HFpEF. (4) Conclusions: The clinical picture and the course of heart failure in patients with and without cancer are different.

Occurrence of Arrhythmias in Women with Thyroid Cancer Receiving Suppressive Doses of Levothyroxine.

Aim of the study: To assess the occurrence of cardiac arrhythmias caused by high doses of levothyroxine in patients with thyroid cancer with subclinical hyperthyroidism. Materials and Methods: This prospective study included 98 women divided into three groups according to plasma thyroid stimulating hormone (TSH) concentration: <0.1 µU/mL, 0.1-0.39 µU/mL, or 0.4-4.0 µU/mL (control group). All participants underwent laboratory tests and an electrocardiography (ECG) Holter test to assess their heart rate and the occurrence of arrhythmias. Statistical analysis assessed differences between groups in all clinical parameters and factors influencing the occurrence of arrhythmias. Results: There were no differences between groups in the maximum, average, or minimum heart rate or in the incidence of the studied cardiac arrhythmias. Heart rate in women with a TSH concentration of <0.1 µU/mL depended on age and the presence of arterial hypertension, and heart rate in women with a TSH concentration of 0.4-4.0 µU/mL depended on free triiodothyronine concentration and the presence of arterial hypertension; no relationship was identified for women with a TSH concentration of 0.1-0.39 µU/mL. One-way logistic regression analysis did not identify any factors influencing the occurrence of arrhythmias. Conclusions: While maintaining normal free triiodothyronine levels, the use of suppressive doses of levothyroxine after thyroidectomy for differentiated thyroid cancer does not induce clinically significant arrhythmias or affect average heart rate. None of the studied clinical parameters influenced the risk of arrhythmia.

A new approach to ticagrelor-based de-escalation of antiplatelet therapy after acute coronary syndrome. A rationale for a randomized, double-blind, placebo-controlled, investigator-initiated, multicenter clinical study.

The risk of ischemic events gradually decreases after acute coronary syndrome (ACS), reaching a stable level after 1 month, while the risk of bleeding remains steady during the whole period of dual antiplatelet treatment (DAPT). Several de-escalation strategies of antiplatelet treatment aiming to enhance safety of DAPT without depriving it of its efficacy have been evaluated so far. We hypothesized that reduction of the ticagrelor maintenance dose 1 month after ACS and its continuation until 12 months after ACS may improve adherence to antiplatelet treatment due to better tolerability compared with the standard dose of ticagrelor. Moreover, improved safety of treatment and preserved anti-ischemic benefit may also be expected with additional acetylsalicylic acid (ASA) withdrawal. To evaluate these hypotheses, we designed the Evaluating Safety and Efficacy of Two Ticagrelor-based De-escalation Antiplatelet Strategies in Acute Coronary Syndrome - a randomized clinical trial (ELECTRA-SIRIO 2), to assess the influence of ticagrelor dose reduction with or without continuation of ASA versus DAPT with standard dose ticagrelor in reducing clinically relevant bleeding and maintaining anti-ischemic efficacy in ACS patients. The study was designed as a phase III, randomized, multicenter, double-blind, investigator-initiated clinical study with a 12-month follow-up (ClinicalTrials.gov Identifier: NCT04718025; EudraCT number: 2020-005130-15).

Lipopolysaccharide-Binding Protein Is an Early Biomarker of Cardiac Function After Radiation Therapy for Breast Cancer.

PURPOSE: To evaluate the prognostic potential of lipopolysaccharide-binding protein (LBP) levels after breast cancer radiation therapy (RT) for incipient cardiac dysfunction. METHODS AND MATERIALS: In this single-centered study, we prospectively enrolled female patients treated for left breast cancer. Healthy age- and sex-matched participants were recruited as controls. LBP levels, cardiac troponin T, N-terminal propeptide of the brain natriuretic peptide, fatty acid binding protein, and C-reactive protein were assessed at three timepoints-before RT, after the last RT fraction, and 1 month after the last fraction. Echocardiographic evaluation was done 3 to 3.75 years after RT. RESULTS: We recruited 51 patients and 78 controls. Baseline LBP concentrations in the study group were significantly higher than in controls at baseline (P < .001), at 24 hours, and at 1 month after RT (P = .003 and P < .001, respectively). Other biomarkers (cardiac troponin T, N-terminal propeptide of the brain natriuretic peptide, fatty acid binding protein, and C-reactive protein) did not differ in any of the timepoints. Posttreatment LBP concentrations were significantly and positively correlated with heart- and lung-associated dose-volume histogram variables. Posttreatment and follow-up LBP levels correlated positively with the E/E' echocardiographic index reflective of the diastolic function. After adjustment for left anterior descending artery mean dose, left ventricle mean dose, mean heart dose, and type of surgery, LBP remained significantly correlated with E/E' when measured 24 hours after RT (beta = 0.41, P = .032) and 1 month after RT (beta = 0.43, P = .028). CONCLUSIONS: Serum LBP concentrations correlate with diastolic function evaluated 3 years after the completion of RT, making LBP a potentially useful prognostic parameter.

Redox Activity of Copper(II) Complexes with NSFRY Pentapeptide and Its Analogues.

The influence of cation-π interactions on the electrochemical properties of copper(II) complexes with synthesized pentapeptide C-terminal fragment of Atrial Natriuretic Factor (ANF) hormone was studied in this work. Molecular modeling performed for Cu(II)-NSFRY-NH2 complex indicated that the cation-π interactions between Tyr and Cu(II), and also between Phe-Arg led to specific conformation defined as peptide box, in which the metal cation is isolated from the solvent by peptide ligand. Voltammetry experiments enabled to compare the redox properties and stability of copper(II) complexes with NSFRY-NH2 and its analogues (namely: NSFRA-NH2, NSFRF-NH2, NSAAY-NH2, NSAAA-NH2, AAAAA-NH2) as well as to evaluate the contribution of individual amino acid residues to these properties. The obtained results led to the conclusion, that cation-π interactions play a crucial role in the effective stabilization of copper(II) complexes with the fragments of ANF peptide hormone and therefore could control the redox processes in other metalloproteins.

Clinical characteristics of patients with myocardial infarction treated in the regional hospital of Radomszczanski District in 2007-2009.

BACKGROUND: Cardiovascular diseases are responsible for about 50% of deaths in Poland. The clinical picture of coronary heart disease has been changing over recent years. AIM: To assess the changes of the clinical characteristics of myocardial infarction (MI) in the population of Radomszczanski District in 2007-2009. METHODS: The retrospective analysis included 756 patients aged between 29 and 93 years (306 women), who were hospitalised due to MI in the Department of Cardiology, District Hospital in Radomsko from 1 January 2007 to 31 December 2009. The following parameters were analysed: frequency of ST elevation MI (STEMI) and non ST elevation MI (NSTEMI) hospitalisations in subsequent years, age, gender, traditional risk factors (hypertension, diabetes, obesity, hypercholesterolaemia, hypertriglyceridaemia, smoking), comorbidities (atrial fibrillation, previous stroke and MI, chronic renal insufficiency) and all-cause in-hospital mortality. RESULTS: Observations have shown that during 2007-2009 the number of hospitalised STEMI increased (p = 0.011) while the number of hospitalised NSTEMI decreased (p = 0.011). The incidence of hypertension, diabetes, obesity, and dyslipidaemia did not change over the three years analysed (p > 0.05). In Radomszczanski District, compared to the Polish population, hypertension, obesity and previous MI occurred less frequently, especially in patients with NSTEMI. The incidence of smoking and diabetes was comparable to that in the Polish population with MI. Frequency of risk factors did not change over three years. CONCLUSIONS: Despite the increase of the hospitalised STEMI/NSTEMI ratio, the incidence of risk factors did not change in the population of Radomszczanski District over the analysed period.

[Role of echocardiography in monitoring of cardiac toxicity of cancer pharmacotherapy. Expert consensus statement of the Polish Clinical Forum for Cardiovascular Imaging]. / Wspólczesna rola echokardiografii w monitorowaniu kardiotoksycznosci leków przeciwnowotworowych. Stanowisko grupy ekspertów polskiego Klinicznego Forum Obrazowania Serca i Naczyn.

Recent oncology development results in significant reduction of morbidity and mortality of several kinds of cancer. Such great achievements are at the cost of frequent cardiotoxicity, which predominantly is manifested as cardiomyopathy, cardiac dysfunction and heart failure (HF). Cardiotoxicity may manifest early - during treatment or late - after treatment completion. There are type 1 - anthracycline-related and type 2 - trastuzumab-related cardiotoxicity. Early detection of cardiotoxicity is crucial for preventing late heart dysfunction and HF. Baseline echocardiographic assessment should be performed in every patient before initiation of cancer treatment and serial monitoring of cardiac safety by means of echocardiography is recommended. The most widely used for this purpose is left ventricular ejection fraction (LVEF) calculated by Simpson's method with 2 dimensional transthoracic echocardiography. LVEF has numerous limitations, among which significant inter- and intraobserver variability, late decrease of LVEF with its often irreversibility are the most important. Noncontrast 3 dimesional echocardiography is the most reproducible technique for LVEF measurement. Newer echocardiographic technique - myocardial strain imaging has the potential to detect early subclinical cardiac dysfunction due to cardiotoxicity and may be used for the prediction of LV dysfunction. The role of other echocardiographic parameters, particularly of LV diastolic function has not been exactly defined in literature. The decision on discontinuation or modification of cancer therapy should be based on 2 improper, separate measurements of particular echocardiographic parameter or better more than 1 improper parameter should be taken into account. After completion of cancer treatment, echocardiography follow-up is recommended to detect late cardiotoxicity.

Heart remodeling induced by adjuvant trastuzumab-containing chemotherapy for breast cancer overexpressing human epidermal growth factor receptor type 2: a prospective study.

We aimed to investigate the cardiac changes in patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer treated with trastuzumab in an adjuvant setting. Two hundred and fifty-three women with HER2-positive breast cancer were included. The assessment of cardiovascular system and echocardiography were performed and compared at baseline, at the termination of trastuzumab therapy and 6 months latter. Left heart remodeling was defined arbitrary as the change in at least one of the analyzed echocardiographic parameters of ≥standard deviation (SD) (in model I) or ≥2×SD (in model II) after 6-month follow-up. After 6-month follow-up 39 (31.7%), 27 (22%), 14 (11.4%), 10 (8.1%), 5 (4.1%) and 1 (0.8%), women had at least one parameter with a change exceeding mean difference ≥SD, respectively; and 30 (24.4%), 9 (7.5%), 3 (2.4%), 2 (1.6%) 1 (0.8%) exceeding mean difference ≥2SD. In stepwise multivariate regression analysis sedentary life style (OR16.7, p=0.003), positive cardiovascular family history (OR 6,9; p=0.013) and left ventricular ejection fraction change after 3 months (OR 1.2; p=0.007) were independent predictors of left heart remodeling in model I, whereas hypertension (OR 5.6; p=0.06) and positive cardiovascular family history (OR 3.9; p=0.032) were independent predictors of heart remodeling in model II. In conclusion, trastuzumab induces LV and left atrial cavity dilatation together with LV systolic function impairment.

[Cardioverter-defibrillator in the treatment of arrhythmia induced by trastuzumab used in the adjuvant setting in a patient with positive human epidermal growth factor receptor type-2 breast cancer]. / Kardiowerter−defibrylator w leczeniu arytmiiwywolanej trastuzumabem stosowanym w terapiiuzupelniajacej u chorej na raka piersi z nadekspresjanaskórkowego receptora wzrostu typu 2.

A case of a 36-year old woman with HER2-positive early breast cancer treated with adjuvant trastuzumab left ventricle dysfunction and cardiac arrest in ventricular fibrillation mechanism is presented. After having been successfully resuscitated, trastuzumab therapy was withheld, pharmacotherapy (beta-blocker, ACE-I) implemented and ICD was implanted. Echocardiography performed 6 months later, revealed normal systolic function of the left ventricle. The patient died despite further oncologic treatment due to progression of the disease. The authors discuss the approach to this dramatic but lone cardiac side effect of trastuzumab treatment.

Cardiac complications associated with trastuzumab in the setting of adjuvant chemotherapy for breast cancer overexpressing human epidermal growth factor receptor type 2 - a prospective study.

INTRODUCTION: Trastuzumab, a recombinant humanized monoclonal antibody, is targeted against the external domain of the human epidermal growth factor receptor type 2 (HER2). It improves efficacy of HER2-positive breast cancer treatment. The authors present their experience with patients (pts) treated with trastuzumab in the aspects of cardiac complications. MATERIAL AND METHODS: We observed prospectively 253 women with early positive HER2 breast cancer treated with trastuzumab. Assessment of cardiovascular status, ECG and echocardiography was performed initially and every 3 months until 6(th) month during follow-up. RESULTS: Cardiac complications developed in 52 pts (20.55%) and included: asymptomatic left ventricle dysfunction (43), symptomatic heart failure (6), new asymptomatic LBBB (1); new negative T-waves in ECG (2). There was a progressive decline in left ventricular ejection fraction (LVEF) during treatment. It was more enhanced in pts with cardiac complications. Following trastuzumab termination/discontinuation LVEF increased but at month 18 still remained significantly lower than initially in both groups (61.07 ±4.84 vs. 59.97 ±5.23 - no cardiac complications; p < 0.05; 58.14 ±4.08% vs. 53.08 ±5.74% - cardiac complications; p < 0.05). During 6-month follow-up 33 out of 46 pts experienced an improvement in left ventricular status. In 13 pts in whom trastuzumab was discontinued, it was restarted; 6 of them successfully completed total therapy. Univariate analysis revealed no association between any cardiovascular risk factor and the development of cardiotoxicity. CONCLUSIONS: One out of five treated patients discontinues trastuzumab in an adjuvant setting due to cardiac complications. LV dysfunction is the most frequent. Routine cardiac monitoring should be obligatory.

Left atrial size in hypertension and stroke.

INTRODUCTION: An enlarged left atrium is associated with increased risk for stroke. However, there are controversies regarding how left atrial size should be measured. MATERIAL AND METHODS: Echocardiography and carotid artery ultrasound were performed in 120 patients with essential hypertension (HT group) and in 64 hypertensive patients admitted with a first-ever ischemic stroke (HT-stroke group). Left atrial size was measured as antero-posterior diameter (LAD) and as left atrial volume (LAV) and indexed to body surface area (LADi/LAVi). All patients were in sinus rhythm and without mitral valve disease. RESULTS: In the HT-stroke group, LAVi and LADi were significantly larger as compared with the HT group (P ≤ 0.03 for all). In bivariate correlations, larger left atrial size was associated with higher SBPs and DBPs and significant carotid artery stenosis both in HT and HT-stroke groups (all P < 0.05). In multivariate logistic regression analysis, stroke was associated significantly with larger LAVi [odds ratio (OR) 1.73, 95% confidence interval (CI) 1.06-2.65]; left ventricular mass index (OR 1.11, 95% CI 1.03-1.21); significant carotid artery stenosis (OR 1.09, 95% CI 1.03-1.24); and any carotid artery stenosis (OR 1.07, 95% CI 1.03-1.14). Analysis of receiver operating characteristic curves revealed that LAVi was the best left atrial measurement for prediction of stroke (OR 0.77, 95% CI 0.70-0.84). CONCLUSION: In hypertensive patients, a first-ever ischemic stroke was associated with larger left atrial size, left ventricular mass index and internal carotid artery stenosis. LAVi was the left atrial measurement most closely associated with ischemic stroke.

Myocardial perfusion GSPECT imaging in patients with myocardial bridging.

BACKGROUND: The aim of this study was to investigate the incidence, reversibility, and severity of LV perfusion abnormalities in patients with isolated myocardial bridges using a gated myocardial perfusion SPECT study (GSPECT). METHODS: A retrospective study involved 42 patients without history of myocardial infarction, with isolated myocardial bridges detected in coronary angiography and no substantial evidence of atherosclerotic changes in coronary arteries. In all patients a gated SPECT study was performed at both rest and stress, after intravenous administration of (99m)Tc MIBI. Reconstructed slices were analyzed using a 20-segment model of the left ventricle. RESULTS: Incidence and severity of stress-induced ischemia were related to degree of artery constriction (P = .002 and .00014, respectively). Perfusion abnormalities were detected only in patients with critical narrowing (≥ 50%) of artery (in 12 out of 28, i.e., 43% of patients). Summed stress scores (SSS) ranged from 4 to 11 (mean 7), indicating slight or moderate defect intensity. Only 1 patient presented with a SSS value of 31 (severe defect). Perfusion defects were stress induced in 70 out of 72 (97%) segments with abnormal perfusion. CONCLUSION: Perfusion abnormalities were observed in ab. 40% of patients with critical (≥ 50%) narrowing of artery affected by bridging and were mild, stress induced.

[Current problems in the diagnosis and treatment of patients with myocarditis]. / Aktualne problemy w rozpoznawaniu i leczeniu chorych na zapalenie miesnia sercowego.

Myocarditis as inflammatory cardiomyopathy is considered to be the primary group acquired cardiomyopathy. It is a disease of diverse etiology, which involves inflammation cardiomyocytes, interstitial tissue, vessels and sometimes the pericardium. The prevalence is not accurately known. Myocarditis is caused by many etiological factors: viruses, bacteria, protozoa and parasites. The presence of eosinophilic myocarditis is related to chemical compounds, including many drugs. This disease, although known for a long time still poses many problems in everyday medical practice. Clinical course of the disease and frequent process of transition dilated cardiomyopathy, tends to isolate the three phases of the disease: viral, autoimmune and dilated cardiomyopathy. These phases arise from the close link between viral infection and the accompanying immune response (especially contagious infection). In fact, the secondary immune response leads to activation of cytotoxic cells (CD8), which gives rise to antibodies directed against cardiomyocytes. Diagnosis of this disease is difficult and expensive, uses methods: direct (culture), molecular (PCR, hybridization) and imaging methods (echocardiography, MRI). Treatment of myocarditis depends on the phase and the etiology of the disease. In phase includes nonspecific viral antiviral agents, and avoidance of potentially harmful immunosuppression. The therapy is used among other immunoglobulins, statins, and patients in the phase dilated cardiomyopathy should be treated as idiopathic dilated cardiomyopathy and congestive heart failure. Myocarditis is one of the few units of cardiac disease for which there are no uniform standards of medical practice.

High sensitivity C-reactive protein, NT-proBNP and hemodynamic left ventricular function in acute coronary syndrome without ST segment elevation - a preliminary report.

BACKGROUND: Prognostic factors in acute coronary syndromes have been the subject of interest in cardiology over the last few years. Our study aimed to compare humoral marker concentration shifts (hsCRP, Nt-proBNP) and hemodynamic left ventricular systolic function index changes, determined by means of echocardiography in the first hours of acute coronary syndromes (ACS). MATERIAL/METHODS: The study comprised 33 patients with ACS without ST segment elevation. Group I consisted of 18 patients (11 men, 7 women aged from 48 to 77, mean age 67+/-35 years) with unstable angina pectoris (uAP). Group II consisted of 15 patients (10 men, 5 women aged from 51 to 80, mean age 70+/-11.9 years) with myocardial infarction without ST segment elevation (NSTEMI). In all patients, Nt-proBNP and hsCRP blood concentrations were determined between the 6th and 12th hours after admission to the intensive coronary care unit. On the 2nd-3rd day, after coronary stabilization, routine echocardiography was performed in each patient to assess left ventricular function. RESULTS: A positive correlation between hsCRP and Nt-proBNP in uAP was observed in group I. In group II, in patients with NSTEMI no such correlation was observed. There was also no correlation in either study group between humoral (hsCRP and Nt-proBNP) and hemodynamic parameters. CONCLUSIONS: The complex evaluation of the post-ACS prognosis should be multifaceted. It should contain hemodynamic assessment of the left ventricle by means of echocardiography as well as humoral coronary risk markers.

Left atrial and left atrial appendage systolic function in patients with post-myocardial distal blocks.

INTRODUCTION: The study aimed to evaluate function of the left atrium (LA) and of the left atrial appendage (LAA) after myocardial infarction (MI) complicated by intracardiac conduction disturbances. MATERIAL AND METHODS: The study comprised 59 patients with persistent post-myocardial distal blocks, who were allocated to one of the three following subgroups: study group I - 20 patients with left bundle branch block (LBBB); study group II - 20 patients with right bundle branch block (RBBB), and study group III -19 pts with left anterior hemiblock (LAHB). The control groups included patients with MI in their history and no BBBs (19 pts - group IV) and clinically healthy people (16 patients - group V). The parameters of LA and LAA systolic function were determined by means of transthoracic (TTE) and transoesophageal echocardiography (TOE). RESULTS: We showed that patients who experienced myocardial infarction not complicated with conduction disturbances expressed compensatory LA systolic function enhancement. In patients with post-myocardial RBBB and LAHB significant enhancement of LA systolic function was observed as well but it was expressed to a lesser degree. There was also a tendency towards deterioration of LA systolic function in patients with post-myocardial LBBB. LBBB did not affect LAA systolic function negatively. CONCLUSIONS: Parameters of LAA systolic function showed its enhancement in all patients after myocardial infarction irrespective of whether it was complicated by conduction disturbances.